Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $128.06 / $250.74	Facility	26	$126.00	$128.06	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.39 / $475.00 / $1,839.39	Professional		$385.39	$475.00	$1,839.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.21 / $158.09 / $567.02	Professional	26	$115.21	$158.09	$567.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $273.27 / $335.00 / $876.26	Professional	TC	$273.27	$335.00	$876.26
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $483.83 / $526.50 / $997.10	Professional		$483.83	$526.50	$997.10
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $121.15 / $129.12 / $162.32	Professional	26	$121.15	$129.12	$162.32
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $362.68 / $402.97 / $874.29	Professional	TC	$362.68	$402.97	$874.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.51 / $619.73 / $1,244.55	Professional		$286.51	$619.73	$1,244.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.81 / $137.63 / $259.44	Professional	26	$84.81	$137.63	$259.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.47 / $428.61 / $1,103.11	Professional	TC	$198.47	$428.61	$1,103.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $337.23 / $435.03 / $784.17	Professional		$337.23	$435.03	$784.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $108.30 / $134.25 / $216.36	Professional	26	$108.30	$134.25	$216.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $227.22 / $293.11 / $599.13	Professional	TC	$227.22	$293.11	$599.13
United Facility/Professional Professional Modifier Low / Median / High Price $310.11 / $522.54 / $1,064.64	Professional		$310.11	$522.54	$1,064.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.30 / $119.81 / $198.25	Professional	26	$64.30	$119.81	$198.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $225.21 / $363.16 / $828.66	Professional	TC	$225.21	$363.16	$828.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $269.77 / $366.19 / $476.05	Professional		$269.77	$366.19	$476.05
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $88.00 / $115.21 / $149.77	Professional	26	$88.00	$115.21	$149.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $181.78 / $250.98 / $320.85	Professional	TC	$181.78	$250.98	$320.85